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Effects of interleukin-2 immunotherapy on renal function.

G A Kozeny¹, J D Nicolas, S Creekmore

¹Department of Medicine, Loyola University Medical Center, Maywood, IL 60153.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|July 1, 1988

Summary

Recombinant interleukin-2 (IL-2) immunotherapy causes fluid retention and kidney issues by increasing vascular permeability, similar to endotoxemia. This cancer treatment leads to edema, azotemia, and electrolyte imbalances without causing renal tubular dysfunction.

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Area of Science:

Nephrology
Oncology
Immunology

Background:

Recombinant interleukin-2 (IL-2) is a novel immunotherapy for malignancies.
IL-2 therapy can cause fluid retention, azotemia, and hypophosphatemia.

Purpose of the Study:

To prospectively evaluate the effects of IL-2 on renal function in cancer patients.
To investigate the mechanisms behind IL-2-induced renal complications.

Main Methods:

Eight patients received IL-2 (10^5 U/kg IV q8h) for five days.
Blood pressure was maintained with dopamine and fluids; indomethacin was administered.
Renal function, acid-base balance, and electrolytes were monitored.

Main Results:

IL-2 induced a syndrome resembling endotoxemia with respiratory alkalosis and hypotension.

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Patients developed significant sodium avidity, edema, and mild elevations in BUN and creatinine.

Hypophosphatemia, hypocalcemia, and hypomagnesemia were common; no renal tubular defects were observed.

Conclusions:

IL-2 increases vascular permeability, leading to edema, sodium retention, and prerenal azotemia.
IL-2 therapy causes respiratory alkalosis and subsequent phosphorus shifts.
No evidence of renal tubular dysfunction was found, suggesting prerenal causes for azotemia.